Maxillary molars distalization: a review

ElBady Mahmoud El-Ashry, Kholod; Abd El-Salam Mohammad Fouda, Maher; Mohammad Hafez, Ahmad

doi:10.21608/mjd.2020.198743

Maxillary molars distalization: a review

Document Type : Original Article

Authors

¹ Teaching Assistant, Department of OrthodonticsProfessor of Orthodontics

² professor of Orthodontics Department of Orthodontics Faculty of Dentistry, Mansoura University

³ Assistant professor of Orthodontics Department of Orthodontics Faculty of Dentistry, Mansoura University.

10.21608/mjd.2020.198743

Abstract

Class II malocclusion is ranked as the most prevalent type of glitches that require orthodontic treatment. It can be managed via several lines of treatment the choice between which must be dependent on each case requirements. Maxillary molars distalization is one of the most popular non extraction alternatives for class II treatment. There are many distalization appliances listed in the literature which can be categorized to either compliance or non-compliance types. Compliance distalization appliances include head gear, Cetlin appliance, Wilson Biometric Distalizing Arch and Carrièredistalizer. Lack of patient cooperation comprises a major problem of these appliances and always leads to lengthy treatment in addition to less than ideal results.
Non-compliance distalization appliances for class II treatment include NiTi coil springs, Pendulum appliance, Distal jet, Keles slider and Fast Back appliance. Most of these appliances gain anchorage from dental structures or Nance palatal holding arch. This always leads to adverse effects as consequences of anchorage loss represented in mesial movement of premolars and anterior teeth, increased overjet and palatal tissue irritation by the non-hygienic Nance acrylic button.
Distalization appliances that involve a stable skeletally anchored modules have recently gained large popularity to avoid anchorage loss. It implies insertion of temporary anchorage devices (TADs) in different location of skeletal structures to receive and resist the reactive forces of distalization. Implant, miniplates and miniscrews are the main TADs used for orthodontic purposes. However, implants and miniplates are not widely used as they are expensive and require special surgical intervention. Miniscerws are the most common type of TADs due to their easy insertion, reasonable cost and many head designs that accommodate different orthodontic uses.